Beyond the lament: & The health checklist:

Beyond the lament: & The health checklist:

Context

• In the light of the recent deaths of several children over a short period in Gorakhpur, the country demands for equity in access to doctors, diagnostics and medicines in rural India.

Explanation:

• The weak nature of rural India’s health systems and the extraordinary patient load on a few referral hospitals has become even more evident from the crisis at the Baba Raghav Das Medical College in Gorakhpur.
• The incident is beyond the lack of oxygen supply, the dysfunctional aspects of the health system are evident from the Comptroller and Auditor General’s report on reproductive and child health under the National Rural Health Mission for the year ended March 2016.
• The picture that emerges in several States is one of inability to absorb the funds allocated, shortage of staff at primary health centres (PHCs), community health centres (CHCs) and district hospitals, lack of essential medicines, broken-down equipment and unfilled doctor vacancies.

Suggestions:

1.It is imperative for the government to recognise the limitations of a market-led mechanism, as the NITI Aayog has pointed out in its action agenda for 2020, in providing for a pure public good such as health.

2.There is a need to move to a single- payer system with cost controls that make efficient strategic purchase of health care from private and public facilities possible.

3. Bringing equity in access to doctors, diagnostics and medicines for the rural population has to be a priority for the National Health Mission.

4.We need to invest in training and deploying professionals in public health management at different levels of the system.

5.Based on a core combination of public health expertise and management skills, further specialisation can be customised for public health programme management and hospital management.

6.The disease surveillance system needs to be strengthened in both community and hospital settings, to provide reliable real-time data.

7The primary healthcare system must be well resourced and adequately staffed, to be capable of early detection and care, appropriate referral for advanced care when needed, and post-recovery counselling and follow-up.

8.Fully functioning health and wellness sub-centres and primary health centres must speedily spring and serve close to the communities rather than rest and rust as undelivered plans in the proposals of health programmes.